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Antimicrobial Resistance (AMR) is part of an evolutionary process where bacteria constantly adapt and develop resistance and no longer respond to available medicines. It is feared that in the future AMR will mean that chemotherapy, knee replacement surgery, and even preterm birth treatments will become extremely risky. AMR is one of the gravest public health threats globally, exerting far-reaching impacts on societies, economies, human, animal, and plant health, and the environment.

Globally, drug-resistant infections already contribute to no fewer than 700,000 deaths a year. If urgent action is not taken, the death toll could skyrocket.

Notwithstanding policy efforts aimed at optimising antibiotic use, average sales across all categories of antibiotics for use in human health have gone up by nearly 2% between 2000 and 2019 in OECD countries, while sales of antibiotics for use in animal health have halved. This period also saw a rise in antibiotic consumption in non-OECD G20 countries in human health, converging towards OECD levels. In G20 countries, sales of antibiotics for use in animal health are expected to be double the OECD average by 2035. Globally, drug-resistant infections already contribute to no fewer than 700,000 deaths a year. If urgent action is not taken, the death toll could skyrocket.

Babies as well as older people will bear the disproportionate health burden, with approximately two-thirds of AMR-related deaths occurring among individuals aged 65 and above. Across OECD countries, resistant organisms cause one in five bacterial infections. In non-OECD G-20 countries such as  Brazil, India and Indonesia, the prevalence of infections caused by drug-resistant bacteria already stood at alarming levels in 2019, ranging from 31 to 57%, surpassing the average of 20% observed in OECD countries.

Resistant infections pose an unsustainable burden on healthcare systems and economies. Every year, 34 OECD and EU/EEA countries spend around EUR 25.3 billion on treating the consequences of resistant infections. Patients in these countries spend around 32.5 million extra days per year in hospitals due to resistant infections. This is equivalent to using the entire acute bed capacity in Spain in 2020 for almost an entire year.  On top of this, the economic cost of AMR reaches approximately EUR 32.3 billion every year due to reduced participation in labour markets and productivity loss.

Unfortunately, there are still important gaps in the implementation of policies to tackle AMR.  While most OECD and EU/EEA countries have national policies for antimicrobial governance, monitoring and evaluation remains weak. A significant knowledge gap also persists in antibiotic awareness amongst the general population. A 2018 Eurobarometer survey  revealed that more than two in five people were unaware that antibiotics are ineffective against viral infections.

Food is an important conduit for the transmission of AMR to humans. Estimates reveal that a substantial portion of the global antibiotic supply, reaching up to 80%, finds application in agri-food systems. 

Food is an important conduit for the transmission of AMR to humans. Estimates reveal that a substantial portion of the global antibiotic supply, reaching up to 80%, finds application in agri-food systems. This is only expected to increase, propelled by the expansion of aquaculture and the growing demand for cost-effective meat consumption within an expanding global population.  

As much as 80% of antibiotics ingested by humans and animals end up in manure and wastewater. This raises a grave implication: the practice of fertilising fields with manure or irrigating them with wastewater could potentially leave behind residues of antibiotics on food crops.

Escalating global temperatures driven by climate change heighten the risk of increased bacterial infection rates and the expansion of diseases into regions where they were previously absent. By using data from 116 countries for the first time, a recent study demonstrated that higher levels of air pollution are linked to elevated risk of AMR.

To combat AMR, we need to embrace a One Health Approach, i.e. a collaborative, multisectoral, and transdisciplinary approach that promotes policy action encompassing people, animals, agri-food systems and the environment, working at the local, regional, national, and global levels. This includes optimising the use of antibiotics in human and animal health, scaling up investments in infection prevention and control in healthcare facilities, strengthening surveillance systems across sectors, mitigating climate change links, and significant investments in R&D and innovation of new medicines, diagnostics, and vaccines.

At all levels, tackling AMR is not an easy task. There is new hope that innovative technologies such as AI and genomic sequencing could help. The AMR Action Fund has been set up to help finance promising antibiotics through the complex and expensive later stages of clinical trials and approvals.

And finally, the approach needs to be global, ensuring problems of overreliance on broad spectrum antibiotics and a lack of diagnosis are addressed in all parts of the world, including in resource poor countries and areas without state-of-the-art healthcare.

The collaborative efforts of governments, multilateral agencies, civil society, and the private sector are crucial. 

The AMR pandemic is already here. Results from new OECD analysis Embracing-a-one-health-framework-to-fight-antimicrobial-resistance demonstrate  that policy action that is grounded in a One Health approach is urgently needed. The collaborative efforts of governments, multilateral agencies, civil society, and the private sector are crucial. Only through a unified front can we hope to mitigate the disconcerting consequences of AMR.

 Join the discussion on Tuesday, 3 October with our latest OECD Forum Virtual Event:

SESSION SCENARIO

 14:30    Welcome and moderation

•  Pamela Druckerman, Journalist, Emmy-winning Documentary Producer and Author

 14:35-14:50 Presentation

•  Francesca Colombo, Head of the OECD Health Division, Directorate for Employment, Labour, and Social Affairs 

 14:50-16:00   Panel Discussion

• Malin Grape, AMR Ambassador, Sweden
• Elzo Kannekens, Director Global Public Policy & Multilateral Affairs, MSD Animal Health
• Steffen Pierini Lüders, Senior Vice President, Corporate Affairs, Novo Nordisk Foundation
• Alexander Pym, Director of Infectious Disease, Wellcome Trust

 16:00    Closing

• Pamela Druckerman, Journalist, Emmy-winning Documentary Producer and Author